Continuation funding is requested to evaluate the health outcomes and economic costs of a postpartum simultaneous early discharge (SED) pilot. The current research is evaluating an existing early discharge situation where patient load requires that some mothers be sent home at 24 hours, although their infants must remain at least 48 hours for mandatory testing. The pilot program will use strict selection criteria and nurse-managed home followup and testing so that mothers and infants can go home together. The SED pilot should provide better health outcomes than the existing early discharge situation at a cost lower than the conventional discharge. A quasi-experimental design will compare 100 mother-infant dyads in the SED pilot to two control groups: 100 conventional discharge dyads and 100 existing early discharge dyads with infant separation. About half the subjects in the current study would meet the stricter selection criteria of the SED pilot , and can be retained as controls. Thus, about 100 new control subjects will be needed. SED pilot and both control groups will be matched for race/ethnicity, maternal age and parity. Outcome criteria evaluated will include: maternal and infant health problems at 7- 10 days postpartum, maternal self-reported worries and concerns, maternal caretaking, maternal attachment behaviors during an infant feeding, maternal assessment of her infant (NPI), and the total cost of in- and out-of-hospital care up to and including 7-10 days postpartum. Early discharge has been successful for middle-class mothers, but its impact on low income mothers has not yet been documented. Pressures to contain health care costs continue to increase, especially for urban hospitals serving many low income mothers. Hospital cost reductions must not compromise the health of low income mothers and infants already at higher than average risk of health problems. The continuation will build on current research to establish feasibility and effectiveness of a postpartum early discharge program for low income mother that uses nurse- managed home followup. If it can be demonstrated that the pilot offers improved health outcomes at a lower cost, results will provide a model highly relevant to nursing and to hospitals throughout the country.